Guider la pratique et la formation éthique des professionnels de la santé : établir les fondements du modèle de la déontologie réflexive (MDR)

Si l’approche par compétences au Canada et aux États-Unis est particulièrement valorisée pour orienter la pratique des professionnels de la santé (PDS) – et en bioéthique clinique –, les travaux permettant de mieux comprendre les fondements psychologiques, ontologiques et philosophiques de ces compétences sont peu présents dans la littérature en bioéthique. Les principaux outils actuellement disponibles se divisent généralement en quatre principales catégories : 1) les documents officiels (codes de déontologie, règlements institutionnels, etc.); 2) les principales théories éthiques (éthique de la discussion, éthique de la vertu, principisme, etc.); 3) les ouvrages de référence scientifiques; 4) les outils de prise de décision éthique. Ces documents sont des incontournables pour les bioéthiciens et les PDS, mais leur disparité, voire leur contenu parfois contradictoire, jumelée à une compréhension limitée de l’éthique, est souvent source de confusion dans les processus décisionnels et peut être la cause de comportements ne répondant pas aux standards éthiques des pratiques professionnelles. Notre recherche constitue une réflexion qui s’inscrit en amont de ces outils dont le caractère pragmatique a le désavantage de simplifier la réflexion théorique au profit de données plus concrètes. Nos travaux visent à développer les bases d’un modèle flexible et inclusif – le modèle de la déontologie réflexive (MDR) – permettant de : 1) poser les principaux repères philosophiques, sociaux et déontologiques des problématiques éthiques rencontrées en pratique; 2) saisir les principales tensions éthiques inhérentes à cette complexité; 3) mieux comprendre, dans une perspective psychologique et développementale, les exigences personnelles et professionnelles qu’impose le statut de professionnel de la santé dans le contexte actuel des soins de santé. Entreprise théorique, ce projet consiste principalement à mettre en relation dynamique un ensemble de dimensions (légale, éthique, clinique, sociale, psychologique) à l’oeuvre dans la rencontre du bioéthicien et du PDS avec la complexité des situations éthiques, en s’inspirant du concept de sensibilité éthique de la « petite éthique » de Paul Ricoeur (1990), du modèle des quatre composantes de Rest (1994) et de la théorie du soi et des modes identitaires d’Augusto Blasi (1993). Ce processus implique trois étapes successives : 1) une mise en ii perspective de la posture épistémologique particulière du bioéthicien et du PDS à la lumière de la « petite éthique » de Ricoeur; 2) une revue de la littérature interdisciplinaire sur le concept de sensibilité éthique afin d’en proposer une définition et de le mettre en perspective avec d’autres compétences éthiques; 3) le développement d’un cadre de référence en matière d’identité éthique professionnelle (professional ethics identity tendencies, PEIT), inspiré de la théorie du soi et des modes identitaires de Blasi. Ces PEIT proposent un repère normatif aux exigences liées à la construction de l'identité en contexte de pratique des PDS et suggèrent des pistes de réflexion quant à la formation et à la recherche en éthique professionnelle. Cette recherche souhaite établir des fondements théoriques pour le développement ultérieur du modèle de la déontologie réflexive (MDR).

Los horarios laborales y su influencia en la percepción del equilibro trabajo-familia

Conciliar el trabajo y la familia es una lucha cotidiana que cada persona realiza para satisfacer las exigencias de ambas dimensiones de su vida. El no tener consciencia del problema que surge en el empleado para lograr esta conciliación y la ausencia de soluciones eficaces a éste, no sólo afecta a la organización a través de la baja productividad, el absentismo, el aumento del estrés, entre otros efectos; sino también a la vida familiar, social, física y psicológica del trabajador. Es por ello, que este proyecto de grado busca a partir de la revisión de la literatura mostrar cómo la percepción que tienen los trabajadores de su equilibrio trabajo-familia, se ve influenciada por un factor organizativo, como lo son los turnos laborales; además evidenciar las soluciones que se han implementado en las diferentes empresas de manera exitósa, para finalmente plantear estrategias que se puedan aplicar en las organizaciones facilitando el equilibrio trabajo-familia de los trabajadores.

Factores de riesgo para enfermedad diarreica e infección respiratoria aguda en niños de Aquitania - Boyacá

Introducción: Este estudio establece la asociación de diferentes factores de riesgo asociados con enfermedad diarreica aguda EDA e infección respiratoria aguda IRA en niños menores de 5 años en el Municipio de Aquitania – Boyacá

Reflections on the concept of the common good from an economic perspective

The chapter considers how the common good can be implemented when opinions differ within society about the nature of the common good. It explains how economic analysis can shed light on efficient conflict-management in these circumstances. The chapter argues, more generally, that virtue theorists make too little use of economics because they have an unduly restricted view of the nature and scope of the discipline

La caze on envy and resentment

Marguerite La Caze has recently published a stimulating analysis of the emotions of envy and resentment in which she argues that to envy others for a benefit they have received or to resent them for such a reason can be ethically acceptable in cases where that benefit has been unjustly obtained (La Caze, 2001). I question this on the ground that the judgement that the benefit has been unjustly obtained plays a more complex role in the structure of envy and resentment than La Caze allows and should alter the nature of the feeling that is evoked. From the perspective of virtue ethics there is nothing creditable about still feeling envy or resentment in such circumstances.

Use of moral theory to analyse the ethical codes of built environment professional organisations: A case study of the Royal Institution of Chartered Surveyors

Purpose – The purpose of this paper is to discuss the use of moral theory as a philosophical analytical framework for built environment organisations' ethical codes of practice. The identified moral theories under consideration are “deontology”, “consequentialism” and “virtue ethics”.

Design/methodology/approach – The paper uses a case study to examine the use of moral theory to explain the ethical codes of practice of built environment professional organisations. The chosen organisation is the Royal Institution of Chartered Surveyors (RICS). The approach for conducting the case study is through semi-structured interviews with experienced RICS members which gather views on the application of moral theory to explain the RICS ethical principles.

Findings – The case study revealed that there are mixed views on the use of moral theory to explain the RICS code of practice. The general view is that deontology is the most suitable theory to explain the fact that the work or process has been undertaken correctly. On the other hand, there is also a view amongst senior professionals that virtue ethics is most appropriate as it addresses the importance of both the correct “result” and the correct “process”.

Research limitations/implications – The paper uses a case study approach to examine the ethical code of one built environment professional organisation. This research does not therefore claim empirical generalisation but instead provides illustrations on the use of moral theory to explain the code of practice of a built environment professional organisation. The paper is based on a series of interviews. The findings should be understood as the aggregated opinions of the interviewees.

Originality/value – The paper makes an original contribution to existing literature on the theoretical analysis of codes of practice for built environment professional organisations. It describes research which is the first to use moral theory as a framework for analysing rules of conduct of built environment professional organisations.

Metrics to assess ecological condition, change, and impacts in sandy beach ecosystems

Complexity is increasingly the hallmark in environmental management practices of sandy shorelines. This arises primarily from meeting growing public demands (e.g., real estate, recreation) whilst reconciling economic demands with expectations of coastal users who have modern conservation ethics. Ideally, shoreline management is underpinned by empirical data, but selecting ecologically-meaningful metrics to accurately measure the condition of systems, and the ecological effects of human activities, is a complex task. Here we construct a framework for metric selection, considering six categories of issues that authorities commonly address: erosion; habitat loss; recreation; fishing; pollution (litter and chemical contaminants); and wildlife conservation. Possible metrics were scored in terms of their ability to reflect environmental change, and against criteria that are widely used for judging the performance of ecological indicators (i.e., sensitivity, practicability, costs, and public appeal). From this analysis, four types of broadly applicable metrics that also performed very well against the indicator criteria emerged: 1.) traits of bird populations and assemblages (e.g., abundance, diversity, distributions, habitat use); 2.) breeding/reproductive performance sensu lato (especially relevant for birds and turtles nesting on beaches and in dunes, but equally applicable to invertebrates and plants); 3.) population parameters and distributions of vertebrates associated primarily with dunes and the supralittoral beach zone (traditionally focused on birds and turtles, but expandable to mammals); 4.) compound measurements of the abundance/cover/biomass of biota (plants, invertebrates, vertebrates) at both the population and assemblage level. Local constraints (i.e., the absence of birds in highly degraded urban settings or lack of dunes on bluff-backed beaches) and particular issues may require alternatives. Metrics - if selected and applied correctly - provide empirical evidence of environmental condition and change, but often do not reflect deeper environmental values per se. Yet, values remain poorly articulated for many beach systems; this calls for a comprehensive identification of environmental values and the development of targeted programs to conserve these values on sandy shorelines globally.

Jornalistas que escrevem sobre saúde conhecem a Humanização do Atendimento?

No Brasil, iniciativas de Humanização no atendimento em saúde são identificadas desde os anos 1990, mas ganharam vulto por meio do Programa Nacional de Humanização da Assistência Hospitalar (PNHAH), ampliado pela Política Nacional de Humanização (PNH). O objetivo deste artigo é identificar a percepção sobre Humanização por parte de alguns jornalistas que escrevem sobre Saúde em importantes publicações paulistas, e no que se constitui, na opinião deles, um atendimento humanizado. A análise do material coletado foi feita segundo referenciais teóricos da Bioética, sob o enfoque de autores como Pellegrino e Thomasma (Ética das Virtudes e Beneficência) e Beauchamp e Childress (Principialismo). Resultados: Os pesquisados ainda associam a Humanização às primeiras iniciativas de Humanização, vinculadas a assistência ao parto e pré-natal, além do voluntariado, mas desconhecem a existência de uma política estruturada sobre o tema: nenhum sequer mencionou a PNH; consideram o médico como figura essencial à Humanização da assistência e que, portanto, deveria ser virtuoso; e desejam que o atendimento tenha caráter integral (holístico).

Must We Forgive?: Exploring the Limits and Possibilities of Forgiveness and Resentment

Conflict has marked civilization from Biblical times to the present day. Each of us, with our different and competing interests, and our desires to pursue those interests, have over time wronged another person. Not surprisingly then, forgiveness is a concern of individuals and groups¿communities, countries, religious groups, races¿yet it is a complex idea that philosophers, theologians, political scientists, and psychologists have grappled with. Some have argued that forgiveness is a therapeutic means for overcoming guilt, pain, and anger. Forgiveness is often portrayed as a coping mechanism¿how often we hear the phrase, ¿forgive and forget,¿ as an arrangement to help two parties surmount the complications of disagreement. But forgiveness is not simply a modus vivendi; the ability to forgive and conversely to ask for forgiveness, is counted as an admirable trait and virtue. This essay will explore the nature of forgiveness, which in Christian dogma is often posited as an unqualified virtue. The secular world has appropriated the Christian notion of forgiveness as such a virtue¿but are there instances wherein offering forgiveness is morally inappropriate or dangerous? I will consider the situations in which forgiveness, understood in this essay as the overcoming of resentment, may not be a virtue¿when perhaps maintaining resentment is as virtuous, if not more virtuous, than forgiving. I will explain the various ethical frameworks involved in understanding forgiveness as a virtue, and the relationship between them. I will argue that within Divine Command Theory forgiveness is a virtue¿and thus morally right¿because God commands it. This ethical system has established forgiveness as unconditional, an idea which has been adopted into popular culture. With virtue ethics in mind, which holds virtues to be those traits which benefit the person who possesses them, contributing to the good life, I will argue unqualified forgiveness is not always a virtue, as it will not always benefit the victim. Because there is no way to avoid wrongdoing, humans are confronted with the question of forgiveness with every indiscretion. Its limits, its possibilities, its relationship to one¿s character¿forgiveness is a concern of all people at some time if for no other reason than the plain fact that the past cannot be undone. I will be evaluating the idea of forgiveness as a virtue, in contrast to its counterpart, resentment. How can forgiveness be a response to evil, a way to renounce resentment, and a means of creating a positive self-narrative? And what happens when a sense of moral responsibility is impossible to reconcile with the Christian (and now, secularized imperative of) forgiveness? Is it ever not virtuous to forgive? In an attempt to answer that question I will argue that there are indeed times when forgiveness is not a virtue, specifically: when forgiveness compromises one¿s own self-respect; when it is not compatible with respect for the moral community; and when the offender is unapologetic. The kind of offense I have in mind is a dehumanizing one, one that intends to diminish another person¿s worth or humanity. These are moral injuries, to which I will argue resentment is a better response than forgiveness when the three qualifications cannot be met.

Tugend, Recht und Moral: Tendenzen der Verantwortungszuschreibung

The attribution of responsibility in world society is increasingly a field of contestation. On the one hand, the perceptions of far-reaching causal and moral links between spatially and temporally distant events are ever more explicitly pronounced; on the other hand, the very complexity of these links often engenders a fragmentation of responsibility in law as well as in moral commitment. Identifying three competing conceptualisations of responsibility, namely a turn to virtue ethics, processes of juridification, and processes of moralisation, this article explores their different temporal and social dimensions, and the effects they each have on the relation between those held responsible and those affected by the situation that is to be accounted for.

The fable of the bees; or, Private vices, publick benefits.

"This edition is limited to 875 copies, of which 750 are for sale."

The fable of the bees, or, Private vices, publick benefits : with an essay on charity and charity schools, and a search into the nature of society.

Page 400 misnumbered 352.

Beyond MacIntyre: grounding the business as practice debate

Alasdair MacIntyre’s distinction between institutions and practices helps illuminate how powerful institutional forces frame and constrain the practice of organizational research as well as the output and positioning of scholarly journals. Yet his conceptual frame is limited, not least because it is unclear whether the activity of managing is, or is not, a practice. This paper builds on MacIntyre’s ideas by incorporating Aristotle’s concepts of poíēsis, praxis, téchnē and phrónēsis. Rather than ask, following MacIntyre, whether management is a practice, this wider network of concepts provides a richer frame for understanding the nature of managing and the appropriate role for academia. The paper outlines a phronetic paradigm for organizational inquiry, and concludes by briefly examining the implications of such a paradigm for research and learning.